Brooke Granstrom

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA60997905 Issued in WA

Practice address

105 W 8TH Ave Ste 150E
Spokane, WA 99204

Phone

(509) 465-3919

Fax

(509) 277-7070

NPI assigned

Aug 29, 2018

Last updated

Oct 9, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1535500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570579200000",
    "number": "1639651474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 E 8TH AVE",
            "address_2": "SUITE 150E",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042318",
            "telephone_number": "509-465-3919",
            "fax_number": "509-468-0705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 W 8TH AVE STE 150E",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "99204",
            "telephone_number": "509-465-3919",
            "fax_number": "509-277-7070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4311 11th Ave NE Ste 200",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981056367",
            "country_code": "US",
            "telephone_number": "206-616-4001",
            "fax_number": "206-616-3889",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANSTROM",
        "first_name": "BROOKE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-29",
        "last_updated": "2019-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60997905",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Ann Grandinetti, MD
• Sarah Grandinetti
• Maura Grandison, LMHCA
• Sara Grangroth, AAC
• Tatyana V Grankin
• Grant W. Hardan OD PLLC
• Devon Asia Grant, M.S., LMHC
• Dominique K Grant, MD
• Elissa Kaelynn Grant, PEER SUPPORT SPECIAL
• Jenna Grant

• Physician Assistant in Spokane, WA
• Providers in Spokane, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.